Undescended testicles

Introduction

Undescended testicles are a common childhood condition where a boy's testicles are not in their usual place in the scrotum.

It's estimated that about one in every 25 boys are born with undescended testicles.

In most cases, no treatment is necessary, as the testicles will usually move down into the scrotum naturally during the first three to six months of life. However, around one in 100 boys has testicles that stay undescended unless treated.

The medical term for having one or two undescended testicles is unilateral or bilateral cryptorchidism.

When to see your GP

Undescended testicles are usually detected during the newborn physical examination carried out soon after birth, or during a routine check-up at six to eight weeks.

See your GP if at any point you notice that one or both of your child's testicles are not in the normal place within the scrotum.

Undescended testicles aren't painful and your child isn't at risk of any immediate health problems, but they should be monitored by a doctor in case treatment is needed later on.

What causes undescended testicles?

During pregnancy, the testicles form inside a baby boy's abdomen (tummy), before slowly moving down into the scrotum about a month or two before birth.

It's not known exactly why some boys are born with undescended testicles. Most boys with the condition are otherwise completely healthy.

Diagnosing undescended testicles

Undescended testicles can usually be diagnosed after a physical examination. This will determine whether the testicles can be felt near the scrotum (palpable) or if they can't be felt at all (impalpable).

This physical examination can sometimes be difficult, so your doctor may need to refer your child to a paediatric surgeon.

No further scans or tests are needed to locate the testicles if they can be felt by the doctor. If they cannot be felt, part of the initial surgical treatment (see below) may involve keyhole surgery (a diagnostic laparoscopy) to see if the testicles are inside the abdomen.

How undescended testicles are treated

If the testicles haven't descended by six months, they're very unlikely to do so and treatment will usually be recommended.

Treatment will usually involve an operation called an orchidopexy to move the testicle(s) into the correct position inside the scrotum. This is a relatively straightforward operation, with a good success rate.

Surgery is ideally carried out before 12 months of age. If undescended testicles are treated at an early age, the risk of fertility problems and testicular cancer can be reduced.

Retractile testicles

In most boys, the testicles can move in and out of the scrotum at different times, usually changing position as a result of temperature changes or feelings of fear or excitement.

This is a separate condition known as retractile testicles.

Retractile testicles in young boys aren't a cause for concern, as the affected testicles often settle permanently in the scrotum as they get older. However, they may need to be monitored during childhood, because they sometimes don't descend naturally and treatment may be required.

See your GP if you notice that your child's testicles are not within the scrotum. Your GP can carry out an examination to determine whether your child's testicles are undescended or retractile.